Organization
NORTHERN INYO HEALTHCARE DISTRICT
Active
Other names
Northern Inyo Hospital Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTIAN WALLIS (CHIEF EXECUTIVE OFFICER)
(760) 873-2838
Entity
Organization
Contact information
Practice address
153 PIONEER LN STE B, BISHOP, CA 93514-2517
(760) 873-2849
(760) 872-5800
Mailing address
150 PIONEER LN, BISHOP, CA 93514-2556
(760) 873-5811
(760) 872-5800
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
240000179
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001589200
—
NV
05
—
058578
—
CA
05
—
BCP08578F
—
CA
05
—
RHM08578F
—
CA
01
—
ZZZ02705Z
BLUE SHIELD PROVIDER #
CA
Enumeration date
10/25/2006
Last updated
04/29/2025
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